Minimally Invasive Valve Surgery With Antegrade Perfusion Strategy Is Not Associated With Increased Neurologic Complications

Minimally Invasive Mitral Valve Surgery: Influence of Aortic Clamping Technique on Early Outcomes

“…In their methods, the authors of the latter study defined less invasive operations as "patients undergoing femoral arterial and femoral or jugular venous cannulation." Therefore, this increased risk has perhaps more to do with perfusion strategy than with surgical incision, an observation which has previously been made by Grossi and colleagues [9].…”

“…Both techniques described in this paper involve the use of retrograde arterial perfusion during CPB, a strategy that has been shown by some authors to increase the risk of neurologic complications due to potential embolization of material from an atheromatous aorta [9,10]. This association is especially significant in older patients with significant vascular comorbidities [11].…”

Mitral valve surgery: Right lateral minithoracotomy or sternotomy? A systematic review and meta-analysis

“…Crossclamping was predominantly performed; endoaortic balloon occlusion was performed in only 19 studies. 5,6,9,15,16,[18][19][20]26,28,29,32,33,35,36,3,42 In 16 studies, direct transthoracic crossclamping was predominantly used. 7,8,[10][11][12][21][22][23][24]30,34,40,41,45 In the rest of the studies (n ¼ 11), both modalities were used in the same proportion or it was not clearly stated which technique was mainly used.…”

Minimally Invasive Mitral Valve Surgery: A Systematic Review

“…The same group [72] reviewed a large minimally invasive valve experience using a robust data collection instrument. The study recruited 3,180 patients undergone to isolated, nonreoperative valve operations: 1,452 (45.7%) aortic valve replacements and 1,728 (54.3%) mitral valve procedures.…”

“…The overall stroke rate was 2.2%, with increased stroke risk associated with an atherosclerotic aorta, cerebrovascular disease, emergent operation, ejection fraction <30% or retrograde perfusion ( P < 0.05 for each), but not with incision location ( P = 0.82). Additionally, the association of retrograde perfusion became insignificant when analyzing patients who were 50 years old or younger [72]. …”